Autism Insurance Bill Likely to Die in Session's Final Days

A bill that would allow children with autism to get health insurance coverage for treatment that passed the House over a year ago looks like it won’t make it across the finish line in the current General Assembly session.

The bill, which would require treatment called applied behavioral analysis to be covered by insurers, was passed by the House of Representatives in May of last year.

Advocates looking to convince lawmakers to pass the autism insurance measure roamed the halls of the General Assembly to speak to legislators early in July. Photo credit: Rose Hoban

Applied behavioral analysis has been shown by research to be one of the most effective treatments in helping children with the disorder to be “mainstreamed” into schools and society.

ABA is covered in more than 35 states, including South Carolina, but North Carolina lags behind.

According to the Centers for Disease Control and Prevention, one in 68 children are diagnosed with autism spectrum disorder, and it’s almost five times more common in boys than girls.

After pushing unsuccessfully both last year and this for Senate movement, House lawmakers rolled the provision into SB 493, a 46-page regulatory reform bill that was referenced to committee after passing the second and third reading in the House.

Advocates had hoped the autism insurance provision would be included in the final budget; but with the release of last night’s document, their hopes were dashed.

“We’re very saddened by that, to be honest with you,” said Jennifer Mahan, vice president for governmental affairs for the Autism Society of North Carolina.

“The services that have demonstrated efficacy are behaviorally based,” said Susan Hyman, a researcher from the University of Rochester in a video interview published today on MedPage Today. She said one recent study demonstrated that “naturalistic” services, such as ABA, which takes place in the home and would have been covered by the bill, are the most effective at helping children with autism.

“We know from new data that’s been published that children who have optimal outcome are diagnosed earlier … and have earlier access to evidence-based behavioral service,” Hyman said.

Mahan said the lack of action has been “incredibly disappointing” for families who have kids who would benefit from getting the coverage.

“It’s looking like it’s not going to happen. I don’t say it won’t happen until everything’s over and the gavel falls,” Mahan said. “But it’s not looking good right now.”